脉浮或弱而热，或恶寒者，阳气虚也，宜补气。脉涩而热者，血虚也，宜补血。午前热
者，
而痛者，邪在内也，宜下之。
一男子溃后发热作痛，脉浮数，按之无力，劳而尤甚。以补中益气汤治之而止；更以十
全大
多于血药。
一男子溃后发热，头痛脉浮紧，虚而兼表邪也。以补中益气汤加川芎、白芷，二剂而止
，更以托里药而愈。
一妇人溃后发热少寐，四肢倦怠。以黄 人参汤治之而安，更以十全大补汤，加贝母、
远志、麦门冬、酸枣仁、香附，月余而敛。
一妇人溃后发热，服清热败毒药愈甚，诊之脉涩，以四物汤加粟壳，乳香、没药，二剂
少止，又二剂而安。
一男子溃后发热，头微痛，日晡尤甚。脉浮，按之则涩。以人参养荣汤加柴胡、地骨皮
而愈，又月余而敛。
一男子溃而恶寒，用四君子汤加桂，倍用黄 、大料，四剂而止。脓水尚多，投八珍汤
加桂，数剂渐少。惟疮口不合，以附子饼，及十全大补汤，每剂加炮附子五分，数剂乃去附子，
又服月余而愈。
一男子溃后，将愈，因劳四肢发热，烦躁不寐。以圣愈汤四剂而宁，更以托里药而愈。
丹溪云∶有四肢热，逢风寒，如炙于火者，是人阴气虚而阳气盛也。
一男子溃后，畏寒脉虚。以四君子加炮姜，四剂而愈。以十全大补汤，月余而敛。仲景
云∶脉虚则血虚，血虚生寒，阳气不足也。疮肿脉虚，宜托里，和养血。信夫！
一 妇发热，日晡愈甚，乃血气虚也。治以四物汤加柴胡、地骨皮而愈。
一妇人溃后发热，服凉药，反畏寒。以十全大补汤，二剂而止，又以托里药而痊。
一男子溃后发热，服凉药益甚。诊之脉浮，乃气虚也。以补中益气汤加五味子、麦门冬
治之而止，更以托里药而敛。
一妇人溃后发热，脉浮而数，虚而兼表证也。以补中益气汤倍用柴胡、升麻，一剂而止
，以托里月余而敛。
一男子患痈，溃而饮酒， 痛发热。服黄连解毒汤，二剂而止，更以托里消毒散而愈。
常治痛而大便秘，脉实者，用清凉饮治之。
一男子脓熟不溃，微痛少食，倦怠发热。余为针之，脓涌出，热益甚，乃虚也。急以人
参黄
发
也。此血虚发躁，当以当归补血汤主之。又有火郁而热者，如不能食而热，自汗气短者，虚
也。以甘寒之剂，泻热补气。如能食而热，口舌干燥，大便难者，以辛苦大寒之剂下之，以
泻火补水。
一男子患漏，时值阴寒，忽恶寒，右手脉有而似无，此胃气虚而不任风寒也。以四君子
汤加
者，又有上焦之邪，隔绝荣卫，不能升降出表而恶寒者。东垣云∶夜则恶寒，昼则安静，是
阴血自旺于阴分也。夜则恶寒，昼亦恶寒，是重阴无阳也。当亟泻其阴，峻补其阳。夜则安
静，昼则恶寒，是阴气上溢于阳中也。
一妇人多怒，手背患疮出血，至夜发热妄语。服清心凉血药，不应，乃热入血室而然也
。遂
东垣曰∶昼则发热，夜则安静，是阳气自旺于阳分也。昼则安静，夜则发热烦躁，是阳气下
陷入阴中也，名曰热入血室。昼则发热烦躁，夜则发热烦躁，是阳无阴也。当亟泻其阳，峻
补其阴。王注云∶病热而脉数，按之不鼓动，乃寒盛格阳而致之，非热也。形证是寒，按之
而脉气鼓击于手下盛者，此为热盛，拒阴而生病，非寒也。又曰∶推而内之，外而不内，身
有热也。《伤寒论》曰∶寸口脉微，为阳不足。阴气上入阳中，则洒淅恶寒，尺脉弱，为阴
不足。阳气下陷入阴中，则发热也。以手扪摸有三法，以轻手扪之则热，重按之则不热，是
热在皮毛血脉也。重按之至筋骨之分，则热蒸手极甚，轻手则不热，是邪在筋骨之间也。轻
手扪之则热，重力以按之不热，不轻不重按之而热，是在筋骨之上，皮毛血脉之下，乃热在
肌肉也。 肺热者，轻手乃得，微按全无，日晡热甚，乃皮毛之热，其证必见喘咳。寒热轻
者泻白散，重者凉膈散、地骨皮散。 心热者，微按至皮肤之下，肌肉之上，轻手乃得。微
按至皮毛之下则热，少加力按之则不热，是热在血脉也。其证烦心，心痛，掌中热而哕。以
黄连泻心汤、导赤散、朱砂安神丸。脾热者，轻手摸之不热，重按至筋骨又不热，不轻不重
，在轻手重手之间，热在肌肉，遇夜尤甚。其证必怠惰嗜卧，四肢不收，无气以动。泻黄散
。肝热者，重按之，肌肉之下，至骨之上，乃肝之热。寅卯间尤甚。其脉弦，四肢满闷，便
难转筋，多怒多惊，四肢困热，筋痿不能起于床。泻青丸、柴胡饮子。 肾热者，轻手重手
俱不热。重手按至骨分，其热蒸手如火。其人骨苏苏如虫蚀，其骨困热不任，亦不能起于床
。滋肾丸主之。按徐用诚云∶手太阴少阴，足太阴厥阴少阴本病，为皮毛肌肉骨分热也。然
面
中热手厥阴少阴太阴。 足下热而痛，足少阴。 足外热，足少阳。 身热肤痛，手少阴。
身前热，足阳明。 洒淅寒热，手太阳。 肩上热，肩似拔，手太阳。中热而喘，足少阴
。肩背热，及足小指外， 胫踝后，皆属足太阳。 一身尽热，狂而妄闻妄见妄言，足阳明。
热而筋纵缓不收，阴痿。足阳明阙阴手少阴。与前热在气血之分，皆诸经现证。脏腑阴阳
，是动所生之本病也。
附方
十全大补汤 治溃疡发热，或恶寒，或作痛，或脓多，或清，或自汗盗汗及流注
瘰便
、连翘，服之自消。
人参 肉桂 地黄（酒洗蒸焙） 川芎 白芍药（炒） 茯苓 白术（炒） 黄 （盐水拌炒）
当
。
四君子汤（方见痔漏门）
四物汤（方见瘰 门）
人参败毒散 治一切疮疡 痛，发寒热，或拘急头痛，脉数有力者。
人参 羌活 独活 前胡 柴胡 桔梗 枳壳 茯苓 川芎 甘草（各一钱） 作一剂，
用水二钟，煎八分，食远服。
清凉饮（方见发背门）
当归补血汤 治疮疡溃后，气血俱虚，肌热躁热，目赤面红，烦渴引饮，昼夜不
息。脉洪大而虚，重按全无，此脉虚血虚也。若误服白虎汤必死，宜此主之。
黄 （炙） 当归（酒拌） 作一剂，水一钟半，煎六分服。
补中益气汤 治疮疡之人，元气不足，四肢倦怠，口干发热，饮食无味，或饮食
失节，或劳倦身热。脉洪大而无力，或头痛，或恶寒自汗，或气高而喘，身热而烦。
黄 （炙，一钱五分） 甘草 人参 当归（酒拌） 白术（炒，各一钱） 升麻 柴胡 陈
皮（各三分） 作一剂，水二钟，姜三片，枣二枚，煎一钟，空心服。
黄 人参汤 治溃疡虚热，无睡少食，或秽气所触作痛。
黄 （盐水拌炒，二钱） 人参 白术（炒） 麦门冬（去心） 当归身（酒拌） 苍术（米泔
浸，
，捣炒） 作一剂，水二钟，姜三片，枣一枚，煎八分，食远服。
人参养荣汤 治溃疡发热，或恶寒，或四肢倦怠，肌肉消瘦，面色痿黄，汲汲短气
，饮食无味，不能收敛。或气血原不足，不能收敛。若大疮愈后，多服之，不变他病。
白芍药（一钱半） 人参 陈皮 黄 （蜜炙） 桂心 当归（酒拌） 白术 甘草（炙，各
一钱）
，姜三片，枣一枚，煎八分，食前服。
附子饼（方见臀痈门）
八珍汤 调和荣卫，顺理阴阳，滋养血气，进美饮食，退虚热，此气血虚之大药
也。
当归（酒拌） 川芎 芍药（炒） 熟地黄（酒拌） 人参 白术 茯苓（各一钱） 甘草（炒，
五分） 作一剂，水二钟，姜三片，枣二枚，煎八分，食前服。
圣愈汤（方见杖疮门）
黄连解毒汤（方见作呕门）
托里消毒散（方见肿疡门）
加味小柴胡汤 治妇女热入血室，致寒热如疟，昼则安静，夜则发热妄语。
柴胡（二钱五分） 黄芩 人参 生地黄 甘草（各一钱） 半夏（六分） 作一剂，水一钟
半，姜三片，煎八分，食远服。
Pulse floating or weak with fever, or accompanied by aversion to cold, indicates deficiency of Yang Qi (deficiency of the body's warming and defensive energy); tonifying Qi is appropriate. Pulse choppy with fever indicates blood deficiency; nourishing Blood is appropriate. Fever occurring in the forenoon (morning) suggests pathogenic factors are internal; purgation should be employed. Severe pain also indicates internal pathogenic factors; purgation should be employed.
A male patient experienced fever and pain after an ulcer erupted. His pulse was floating and rapid, but empty upon deep pressure, and symptoms worsened with exertion. He was treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), which stopped the fever; subsequently, Shiquan Dabu Tang (Ten Complete Tonification Decoction) was used with increased dosage of Blood-nourishing herbs.
A male patient had fever, headache, and a floating-tight pulse after an ulcer erupted, indicating deficiency combined with exterior pathogenic factors. He was treated with Buzhong Yiqi Tang plus Chuanxiong Rhizoma (Chuanxiong) and Baizhi Rhizoma (Baizhi). After two doses, the fever ceased, and he recovered with interior-supporting herbs.
A female patient had fever, insomnia, and limb fatigue after an ulcer erupted. She was stabilized with Renshen Baidu San (Ginseng Resisting Toxin Powder) and then treated with Shiquan Dabu Tang plus Fritillariae Bulbus (Beimu), Polygalae Radix (Yuanzhi), Ophiopogonis Tuber (Maidong), Ziziphi Spinosomi Semen (Suanzaoren), and Cyperi Rhizoma (Xiangfu). The wound healed after more than a month.
A female patient had fever after an ulcer erupted, and her condition worsened after taking heat-clearing and detoxifying herbs. Her pulse was choppy. She was treated with Siwu Tang (Four Substances Decoction) plus Papaveris Pericarpium (Husupi), Commiphora Myrrha Resin (Ruxiang), and Boswellia Carterii Resin (Moyao). Symptoms subsided slightly after two doses and resolved after another two doses.
A male patient had fever and mild headache after an ulcer erupted, worsening at dusk (day-bu). His pulse was floating and choppy upon deep pressure. He was cured with Renshen Yangrong Tang (Ginseng Nourishing Harmony Decoction) plus Bupleuri Radix (Chaihu) and Dictamni Cortex (Digupi), and the wound healed after more than a month.
A male patient felt aversion to cold after an ulcer erupted. He was treated with Sijunzi Tang (Four Gentlemen Decoction) plus Cinnamomi Ramulus (Guizhi), with doubled dosages of Astragali Radix (Huangqi) and other major ingredients. Aversion to cold ceased after four doses. There was still much pus and fluid, so Bazhen Tang (Eight Treasures Decoction) plus Guizhi was administered. After several doses, the discharge gradually decreased. Since the wound did not close, Fuzi Bing (Aconite Cake) was applied externally, and internally, Shiquan Dabu Tang was given with Pao Fuzi (Prepared Aconiti Lateralis Radix, 5 fen per dose). After several doses, Fuzi was removed, and treatment continued for over a month until recovery.
A male patient, near recovery from an ulcer, developed fever in the limbs, irritability, and insomnia due to overexertion. He was calmed with Shengyu Tang (Holy Salvation Decoction) for four doses and recovered with interior-supporting herbs.
Danxi stated: "Fever in the limbs that feels like burning when exposed to wind and cold indicates Yin Qi deficiency and Yang Qi excess."
A male patient felt aversion to cold and had a deficient pulse after an ulcer erupted. He was cured with Sijunzi Tang plus Pao Jiang (Prepared Zingiberis Rhizoma) in four doses. He healed with Shiquan Dabu Tang after more than a month. Zhang Zhongjing said: "Deficient pulse indicates blood deficiency; blood deficiency generates cold, which is insufficient Yang Qi." For swelling with a deficient pulse, interior support and harmonizing/nourishing Blood are appropriate. This is true!
A female patient had fever, worsening at dusk, due to Qi and Blood deficiency. She was cured with Siwu Tang plus Chaihu and Digupi.
A female patient had fever after an ulcer erupted. After taking cooling herbs, she became more averse to cold. She was cured with Shiquan Dabu Tang in two doses, followed by interior-supporting herbs.
A male patient had fever after an ulcer erupted, worsening with cooling herbs. His pulse was floating, indicating Qi deficiency. He was treated with Buzhong Yiqi Tang plus Schisandrae Fructus (Wuweizi) and Maidong. The fever ceased, and the wound healed with interior-supporting herbs.
A female patient had fever after an ulcer erupted, with a floating and rapid pulse, indicating deficiency combined with exterior syndrome. She was treated with Buzhong Yiqi Tang with doubled Chaihu and Shengma. The fever ceased after one dose, and the wound healed with interior-supporting herbs after more than a month.
A male patient with an abscess drank alcohol after eruption, leading to pain and fever. The fever ceased after two doses of Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity), and he recovered with Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder).
For abscesses with constipation and a solid pulse, Qingliang Yin (Cooling Drink) is typically used.
A male patient had mature pus but no rupture, with mild pain, poor appetite, fatigue, and fever. I punctured it, causing pus to gush out and fever to intensify, indicating deficiency. Urgent administration of large doses of Renshen (Ginseng) and Huangqi (Astragalus) stopped the fever. This is irritability due to Blood deficiency, treated primarily with Danggui Buxue Tang (Angelica Tonifying Blood Decoction). Another type is heat due to Fire stagnation: if one cannot eat but has fever, spontaneous sweating, and shortness of breath, it is deficiency. Use sweet-cold herbs to clear heat and tonify Qi. If one can eat but has fever, dry mouth/tongue, and difficult defecation, use bitter-warm and great-cold herbs to purge, clearing fire and nourishing water.
A male patient with a fistula suddenly felt aversion to cold during cold weather, with a faint pulse on the right hand, indicating Stomach Qi deficiency unable to withstand wind-cold. He was treated with Sijunzi Tang plus... [text missing] ... There are also cases where Upper Jiao pathogens block Ying and Wei, preventing ascending/descending and exiting the exterior, causing aversion to cold. Dongyuan said: "Aversion to cold at night and quietness during the day indicates abundant Yin Blood in the Yin aspect. Aversion to cold both day and night indicates heavy Yin without Yang; urgently purge Yin and vigorously tonify Yang. Quietness at night and aversion to cold during the day indicates Yin Qi overflowing into Yang."
A female patient prone to anger suffered bleeding from a sore on the back of her hand, followed by nighttime fever and delirium. Heart-clearing and Blood-cooling herbs were ineffective; this was Heat entering the Blood Chamber. Thus... [text missing]. Dongyuan said: "Fever during the day and quietness at night indicates abundant Yang Qi in the Yang aspect. Quietness during the day and fever/irritability at night indicates Yang Qi sinking into Yin, named 'Heat entering the Blood Chamber.' Fever and irritability both day and night indicate Yang without Yin; urgently purge Yang and vigorously tonify Yin." Wang Bing noted: "Fever with a rapid pulse that does not throb upon deep pressure indicates Cold excess repelling Yang, not true heat. Signs of Cold with a strong, throbbing pulse upon deep pressure indicate Heat excess rejecting Yin, not Cold." Also: "Pushing inward, external but not internal, indicates body heat." Shanghan Lun states: "Micro pulse at Cun indicates insufficient Yang. Yin Qi entering Yang causes shivering aversion to cold. Weak pulse at Chi indicates insufficient Yin. Yang Qi sinking into Yin causes fever." Palpation methods: Light touch reveals heat in skin/vessels; deep pressure to bones reveals intense heat in bone/muscle; light touch cool, deep pressure cool, medium pressure hot indicates heat in muscle. Lung Heat: Light touch detects heat, none on slight pressure, worse at dusk, indicates skin/lung heat with cough/asthma. Mild cases: Xiebai San; severe: Liangge San, Digupi San. Heart Heat: Slight pressure below skin above muscle, light touch detects heat, slight pressure removes heat, indicates vessel heat with vexation, heart pain, palm heat, hiccups. Treat with Huanglian Xiexin Tang, Daochi San, Zhusha Anshen Wan. Spleen Heat: No heat on light touch, no heat on deep pressure to bone, heat between light/deep pressure in muscle, worse at night, with lethargy, limb heaviness, lack of Qi. Treat with Xiehuang San. Liver Heat: Deep pressure below muscle to bone indicates Liver Heat, worse at Yin/Mao hours (3-7 AM), wiry pulse, limb fullness, difficult bowel movements, spasms, anger,惊悸, limb heat, tendon weakness. Treat with Xieqing Wan, Chaihu Yinzi. Kidney Heat: No heat on light/deep touch; deep pressure to bone reveals intense heat like fire, bone tingling as if eaten by insects, unbearable bone heat, inability to rise. Treat with Zishen Wan. Xu Yongcheng noted: Hand Taiyin/Shaoyin, Foot Taiyin/Jueyin/Shaoyin primary diseases correspond to skin/muscle/bone heat. Face center heat: Hand Jueyin/Shaoyin/Taiyin. Sole heat/pain: Foot Shaoyin. Outer foot heat: Foot Shaoyang. Body heat/skin pain: Hand Shaoyin. Front body heat: Foot Yangming. Shivering chills/fever: Hand Taiyang. Shoulder heat/shoulder pulling: Hand Taiyang. Center heat/wheezing: Foot Shaoyin. Shoulder/back heat, outer little toe, posterior tibia/ankle: Foot Taiyang. Whole body heat, mania, hallucinations: Foot Yangming. Heat with flaccid tendons, impotence: Foot Yangming/Jueyin, Hand Shaoyin. These are manifestations of various meridians. Zang-Fu Yin-Yang are the root diseases of movement and generation.
Attached Formulas
Shiquan Dabu Tang (Ten Complete Tonification Decoction): Treats ulcer fever, aversion to cold, pain, excessive/clear pus, spontaneous/night sweats, flowing nodules, scrofula.
Ingredients: Renshen (Ginseng), Rougui (Cinnamon Bark), Dihuang (Rehmanniae Radix Praeparata, wine-washed steamed), Chuanxiong (Chuanxiong Rhizoma), Baishao (White Peony Root, stir-fried), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried), Huangqi (Astragali Radix, salt-water stir-fried), Danggui (Angelicae Sinensis Radix), Gancao (Licorice Root).
Sijunzi Tang (Four Gentlemen Decoction) (See Hemorrhoid/Fistula Section)
Siwu Tang (Four Substances Decoction) (See Scrofula Section)
Renshen Baidu San (Ginseng Resisting Toxin Powder): Treats all sores/abscesses with chills/fever, stiffness/headache, forceful rapid pulse.
Ingredients: Renshen, Qianghuo, Duhuo, Qianhu, Chaihu, Jiegeng, Zhike, Fuling, Chuanxiong, Gancao (1 qian each). One dose, boil in 2 zhong water to 8 fen, take far from meals.
Qingliang Yin (Cooling Drink) (See Back Carbuncle Section)
Danggui Buxue Tang (Angelica Tonifying Blood Decoction): Treats post-ulcer Qi/Blood deficiency, muscle heat/restlessness, red eyes/face, thirst, continuous day/night. Pulse large/vacuous, empty on deep pressure. Misusing Baihu Tang is fatal; use this.
Ingredients: Huangqi (Roasted), Danggui (Wine-mixed). One dose, boil in 1.5 zhong water to 6 fen.
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction): Treats ulcer patients with insufficient Yuan Qi, limb fatigue, dry mouth/fever, loss of taste, irregular diet, or fatigue fever. Pulse large/weak, headache, aversion to cold/sweating, high breathing/asthma, body heat/vexation.
Ingredients: Huangqi (Roasted, 1.5 qian), Gancao, Renshen, Danggui (Wine-mixed), Baizhu (Stir-fried, 1 qian each), Shengma, Chaihu, Chenpi (0.3 qian each). One dose, boil in 2 zhong water with 3 ginger slices, 2 jujubes to 1 zhong, take on empty stomach.
Huangqi Renshen Tang (Astragalus and Ginseng Decoction): Treats ulcer deficiency heat, insomnia, poor appetite, or pain triggered by foul odors.
Ingredients: Huangqi (Salt-water stir-fried, 2 qian), Renshen, Baizhu (Stir-fried), Maidong (Heart removed), Dangguishen (Wine-mixed), Cangzhu (Rice water soaked, ... stir-fried). One dose, boil in 2 zhong water with 3 ginger slices, 1 jujube to 8 fen, take far from meals.
Renshen Yangrong Tang (Ginseng Nourishing Harmony Decoction): Treats ulcer fever, aversion to cold, limb fatigue, muscle wasting, sallow complexion, shortness of breath, loss of taste, failure to heal. Or congenital Qi/Blood insufficiency preventing healing. Safe for long-term use post-large ulcer.
Ingredients: Baishao (1.5 qian), Renshen, Chenpi, Huangqi (Honey-roasted), Guixin, Danggui (Wine-mixed), Baizhu, Gancao (Roasted, 1 qian each), ..., 3 ginger slices, 1 jujube, boil in 2 zhong water to 8 fen, take before meals.
Fuzi Bing (Aconite Cake) (See Buttock Abscess Section)
Bazhen Tang (Eight Treasures Decoction): Harmonizes Ying/Wei, regulates Yin/Yang, nourishes Qi/Blood, improves appetite, clears deficiency heat. Major medicine for Qi/Blood deficiency.
Ingredients: Danggui (Wine-mixed), Chuanxiong, Shaoyao (Stir-fried), Shudihuang (Wine-mixed), Renshen, Baizhu, Fuling (1 qian each), Gancao (Stir-fried, 0.5 fen). One dose, boil in 2 zhong water with 3 ginger slices, 2 jujubes to 8 fen, take before meals.
Shengyu Tang (Holy Salvation Decoction) (See Staff Injury Section)
Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) (See Vomiting Section)
Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder) (See Ulcerated Swelling Section)
Jiawei Xiao Chaihu Tang (Modified Minor Bupleurum Decoction): Treats women with Heat entering Blood Chamber causing malaria-like chills/fever, quiet by day, fever/delirium by night.
Ingredients: Chaihu (2.5 qian), Huangqin, Renshen, Shengdihuang, Gancao (1 qian each), Banxia (0.6 fen). One dose, boil in 1.5 zhong water with 3 ginger slices to 8 fen, take far from meals.